Recently, I got a call from a concerned mother who’d been referred to a registered dietitian because of her son’s weight. When she and her son saw the pediatrician for an annual checkup, the doctor…
Recently, I got a call from a concerned mother who’d been referred to a registered dietitian because of her son’s weight. When she and her son saw the pediatrician for an annual checkup, the doctor suggested that his weight was cause for concern. Now this mom sits across from me confused and wondering where she went wrong.
I am no stranger to this type of referral, and these parents have done nothing wrong. A parent takes a child in for a regular checkup, the child gains weight (which is normal), the growth chart has a bump up in the curve (also normal), and the parent (and sometimes the child) is subsequently informed that because of the child’s weight, something needs to be fixed or changed.
Although the American Academy of Pediatrics issued guidelines in 2016 suggesting that weight not be discussed with children and that behavioral recommendations like family meals and fun movement be the focus of patient encounters instead of weight conversations, weight-centric advice and referrals are still commonplace. These wellness (versus weight) guidelines should have a trickle-down effect on other health professionals and schools, but this big change hasn’t had the swift impact one would expect.
Here’s what parents can do to advocate for children’s wellness now:
Speak to your child’s health professional in advance.
Almost every doctor’s visit starts with a weight check. Weight, among many other measures like height, are benchmarks for growth and development. A weight check for a child a couple times of year makes sense to plot a growth curve. Repeated weight checks during medical visits for pink eye that just won’t go away does not.
When I take my daughter to the doctor and know it’s been a while since our last visit, I’m OK with a quick weight check. But I lead the process by saying, “buddy, let’s see how strong you are,” and telling the nurse that we do not discuss numbers in front of her. Parents can ask health professionals not to talk about weight or growth charts in front of their children.
Bodies come in all shapes and sizes. We can’t determine someone’s health by looking at them or by having that person step on a scale. When we learn to appreciate and respect these differences, we’re promoting weight inclusivity and body diversity. “Best care practices from the frontlines of both eating disorder care and social justice are showing that a weight-inclusive approach works best both psychologically and medically,” says Dr. Jennifer L. Gaudiani, an internal medicine physician who specializes in eating disorders and the author of “Sick Enough: A Guide to the Medical Complications of Eating Disorders.” “Body diversity must be honored.”
When we’re talking about differences in bodies, shapes and abilities in our home, we use the mantra “all bodies are good bodies.”
Use supportive language during normal growth stages.
I remember feeling so uncomfortable in my body during pubertal development. We now understand that children anywhere between the ages of 7 and 13 years old can have a period of rapid weight gain prior to starting puberty. Oh to know that the strange and uncomfortable changes in my body were just a part of normal development.
We as parents can remind our children that these rapid changes are signs that development is on target and that our bodies are just the size and shape that they’re supposed to be. We can also be their advocate when a friend or family member makes a comment about our child’s weight gain during this time. Saying something to the effect of “she’s right on target for normal development and thank you for not discussing weight in our home” can shut down an unwanted discussion in a snap.
Focus on wellness behaviors in your home, not weight.
As much as the diet industry would like us to believe otherwise, weight is not a behavior we can control. We can focus our efforts on behaviors that impact our overall wellness instead like planning family meals, incorporating joyful movement, getting enough rest and limiting screen time. Gaudiani also uses this approach in her outpatient medical clinic in Denver, which cares for patients of all ages, genders and body sizes from across the United States.
She says that “drawing attention to weight itself as a concerning or shameful finding is more likely to stimulate disordered eating behaviors and risks triggering future eating disorders. By contrast, when the focus is not on weight but on emotional support and eating and movement behaviors — favoring balanced, satisfying, regular meals and joyful movement according to the child’s interests and abilities — children thrive and learn skills they need for the rest of their lives.”